Provider Demographics
NPI:1861473696
Name:THE ORTHO REMEDY, INC.
Entity Type:Organization
Organization Name:THE ORTHO REMEDY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:VALENTI
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:201-943-3900
Mailing Address - Street 1:522 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1636
Mailing Address - Country:US
Mailing Address - Phone:201-943-3900
Mailing Address - Fax:201-943-9055
Practice Address - Street 1:522 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1636
Practice Address - Country:US
Practice Address - Phone:201-943-3900
Practice Address - Fax:201-943-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45PO00005600335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2986906Medicaid
NY00794050Medicaid
NJ2986906Medicaid